Article

What Is a Diagnostics Management Team?

What Is a Diagnostics Management Team?
OPERATIONAL

Article highlights:

  • Health care institutions are constantly seeking new ways to advance accountable care                          
  • This creates high-value opportunities for labs to partner with IT
  • Read on to learn three things labs and IT can start doing today to drive better outcomes

Diagnostic errors remain among the nation's most troubling healthcare issues, accounting for as much as 17 percent of adverse events in U.S. hospitals. Medical errors contribute to approximately 10 percent of patient deaths and are the leading type of paid medical malpractice claims.1 Fortunately, there is a solution that can reduce the medical errors caused by a delayed or incorrect diagnosis by helping doctors order the correct tests and interpret the results correctly: Diagnostic Management Teams.

Roots of the Problem

 

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The trouble stems from the selection and interpretation of laboratory tests—major challenges for physicians in the course of patient treatment.

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In fact, doctors' difficulties trace back to medical education: In roughly 90 percent of U.S. medical schools, students receive only about 9 hours of training over 4 years on lab test selection and result interpretation.2

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Then, when they reach real-world practice, most doctors rely on what was current during their education to make diagnostic decisions.3

Bottles Fill

With more than 5,000 clinical laboratory tests currently available—and growing in number rapidly—it's not surprising that doctors don't know which lab tests to order for 23 million patient visits annually.

Then, once tests are done, doctors are often unsure of how to interpret the results.4

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Innovative Solution

 

Instead of muddling through a broken process, forward-thinking hospitals, health systems, and practices are providing actionable diagnostic reports to front-line physicians. They're creating diagnostic management teams (DMTs), groups of conferring doctors trained to merge diagnostic and clinical patient data. The DMT generates an accurate diagnosis or short list of diagnostic options and quickly provides that information to the treating provider in the form of an understandable narrative.

Let's walk through how DMTs can turn diagnostics into an area of strength.

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Diagnostics Without DMTs

 

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In a healthcare organization using a conventional approach—without a DMT—the treating physician orders specific tests based on assessment of the patient. To make matters more confusing, the same test may be called by many different names (e.g., 5–10 different names for the same test to measure the amount of vitamin D in the blood), long test names are abbreviated so they can no longer be understood, and some tests are identified by the method used rather than by what they measure. In many cases, the doctor guesses about test selection and often doesn't know the cost of the ordered tests.5 He or she may order multiple tests unnecessarily, with costs for useless information running into thousands of dollars. The laboratory then returns raw results to the ordering doctor, who's left to assemble and try to make sense of the information.

DMTs to the Rescue

 

In contrast, a DMT works with the patient's blood sample and uses evidence-based algorithms to determine only the necessary tests to reach a definitive diagnosis. The diagnosis in a paragraph understandable to all healthcare providers is quickly provided back to the ordering doctor. While the diagnosis is being determined by the DMT, the ordering doctor can proceed to caring for other patients.

The DMT reduces unnecessary testing, increases the use of the most informative tests, and then tells the ordering doctor what the test results mean in the form of a expert-driven, patient-specific narrative.

In short, a quick, accurate diagnosis gets the patient diagnosed and trreated sooner—thanks to the DMT.

Let's walk through how DMTs can turn diagnostics into an area of strength.

DMT Puzzle

Simplified, Streamlined and Actionable

 

Before DMT

This is how lab test data with hopelessly confusing test abbreviations would appear in a hospital's medical record prior to implementation of a DMT for coagulation interpretations. The ordering doctor has selected 13 tests, but still has no diagnosis. In fact, some tests needed to make the diagnosis were not ordered.

Now look at the same patient’s medical record after a DMT interprets complex evaluations from the coagulation laboratory. The treating doctor didn't need to know the exact tests to order. The lab directors on the DMT read the patient's clinical record, reviewed the test results, and then explained in the narrative the possible diagnoses and what the treating doctor should do next.

After DMT

Lower Costs, Improved Outcomes

 

At institutions such as Massachusetts General Hospital and Vanderbilt University Medical Center, DMTs have demonstrated the ability to save money and improve patient outcomes.

Decrease in cost per interaction

Cost per patient encounter decreased due to a drop in unnecessary tests.

Expedited diagnoses led to shorter hospital stays for inpatients (a savings approximated at $2,000 per day).

Vanderbilt estimated its savings from five DMTs at about $3 million over 3 years.

 

At the same time, increased use of appropriate tests resulted in fewer clinical complications than would have otherwise occurred. Patients required fewer repeat visits, saving time for treating doctors and increasing the overall number of patients seen.

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